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Wednesday, March 17, 2010

How do you know someone is a CO2 retainer

Every week I check my statcounter to see who's typing things into Google or Yahoo and being linked to my RT Cave blog. Assuming the queries were not answered, I provide in this spot each week my humble responses.And, hey, if the query is comical, it deserves a comical response. If it's serious, I treat it as serious. That in mind, here are this weeks queries:

1. how do you know someone is a co2 retainer: Their CO2 is elevated, the pH is normal and the HCO3 is elevated. An example gas on room air would be CO2 50, pH 7.40, HCO3 36, PO2 55. Usually the HCO3 will be in the 30s.

2. particle size of advair: For particles to impact in the bronchioles of the lungs the particle size has to be about 0.5 microns.

3. ink: We still need it occasionally when we write in the charts, and to take notes on our clipboards.

5. does albuterol contain alcohol: Some of the new HFA bronchodilators do contain ethonol. You'll have to check the package insert to see if your inhaler does. For more information check out #3 above.

6. too tight to hear a wheeze: Sometimes a patient's lungs are so tight you will not hear a wheeze. In fact, it is quite common that bronchospasm does not result in a wheeze in both COPD and asthma patients. I've written here before that I think most wheezes that are heard are not bronchospasm (you can read more here). The best indicators of bronchospasm in my opinion are diminished lung sounds and shortness of breath.

7. asthma go away: There is no cure for asthma. However, by working with you doctor to find the best combination of asthma medicines most asthmatics do manage to gain control of their asthma (check out this post). Be patient, however, because it may take time. You will also have to do your part by learning of and avoiding your asthma triggers, taking all your medicines exactly as prescribed (check out this post). This includes taking your asthma controller meds even when you feel well. It is also recommended you have an asthma action plan to help you decide what to do when you question yourself. Check out the links in this answer and you should be well on your way to better asthma control.

8. how success came about : How do you define success? Do you define it by how much money you make? How much love you get? How happy you are? How satisfied you are? I like to define success as satisfaction. Either way, there is only one way to achieve success and that is by using common sense and making a gallant effort to do your best at whatever you do.

10. deep breathing exercises prevent pneumonia for immobile patient: It can but there is no guarantee. What you have to realize is that healthy people sigh 3-4 times every hour, and the reason they do this is to stretch and exercise the parts of the lungs that are not used on a regular basis -- like the lung bases. This ultimately prevents the alveolar sacks from collapsing (atelectasis) and can also prevent pneumonia. It helps you to expectorate any secretions deep in your lungs, particularly in the bases of your lungs. Taking 4-10 deep breaths with a 3-10 second breath hold has been proven to prevent pneumonia.

If you disagree or agree with my opinion feel free to leave a comment below, as we are all entitled to an opinion. If you have further comments or questions, feel free to write it below or email me.